Andreas Persson
Senior lecturer
Nationwide study of appendicitis in children
Author
Summary, in English
Background: Paediatric surgical care is increasingly being centralized away from low-volume centres, and prehospital delay is considered a risk factor for more complicated appendicitis. The aim of this study was to determine the incidence of paediatric appendicitis in Sweden, and to assess whether distance to the hospital was a risk factor for complicated disease. Methods: A nationwide cohort study of all paediatric appendicitis cases in Sweden, 2001–2014, was undertaken, including incidence of disease in different population strata, with trends over time. The risk of complicated disease was determined by regression methods, with travel time as the primary exposure and individual-level socioeconomic determinants as independent variables. Results: Some 38 939 children with appendicitis were identified. Of these, 16·8 per cent had complicated disease, and the estimated risk of paediatric appendicitis by age 18 years was 2·5 per cent. Travel time to the treating hospital was not associated with complicated disease (adjusted odds ratio (OR) 1·00 (95 per cent c.i. 0·96 to 1·05) per 30-min increase; P = 0·934). Level of education (P = 0·177) and family income (P = 0·120) were not independently associated with increased risk of complicated disease. Parental unemployment (adjusted OR 1·17, 95 per cent c.i. 1·05 to 1·32; P = 0·006) and having parents born outside Sweden (1 parent born in Sweden: adjusted OR 1·12, 1·01 to 1·25; both parents born outside Sweden: adjusted OR 1·32, 1·18 to 1·47; P < 0·001) were associated with an increased risk of complicated appendicitis. Conclusion: Every sixth child diagnosed with appendicitis in Sweden has a more complicated course of disease. Geographical distance to the surgical facility was not a risk factor for complicated appendicitis.
Department/s
- Pediatric surgery
- Centre for Geographical Information Systems (GIS Centre)
- Dept of Physical Geography and Ecosystem Science
- EPI@LUND
- Surgery and public health
- eSSENCE: The e-Science Collaboration
- EpiHealth: Epidemiology for Health
Publishing year
2019-08-06
Language
English
Pages
1623-1631
Publication/Series
British Journal of Surgery
Volume
106
Issue
12
Document type
Journal article
Publisher
Oxford University Press
Topic
- Public Health, Global Health, Social Medicine and Epidemiology
Status
Published
Research group
- Pediatric surgery
- EPI@LUND
- Surgery and public health
ISBN/ISSN/Other
- ISSN: 0007-1323